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DANE COUNTY ZONING PERMIT DCPZP 2015 00051 Pagel of <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DEP PROPERTIES LLC (608)838-7794 Grant Signs (608)838-7794 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7811 MANISTEE CT 2810 Syene Road <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA,WI 53593 Madison, WI 53713 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dan @grantsigns.net dan @grantsigns.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0709-353-9931-8 TOWN OF MADISON 35 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 2810 SYENE RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 08784 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: CENSUS CODE <br /> C-2 Commercial 1.363 Description:12'x 8'x 20'pylon sign 329-Other <br /> District <br /> Category 0 Residential 0 Commercial Agricultural SEWER SANITARY PERMIT NO. <br /> iOther:SIGN REFACE Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other DCPZP-1965-01053 ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO 0 YES ® NO 0 YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 20 Sq.Ft. Sq.Ft.96 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR #Error <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $100.00 <br /> I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of <br /> the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure <br /> to comply with any provision or condition of this permit renders this zoning permit null and void and subject, <br /> to enforcement action. <br /> I acknowledge that I am responsible for complying with State and Federal laws concerning construction <br /> near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult <br /> to identify. Failure to comply may result in removal or modification of construction that violates the law or <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. <br /> I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the <br /> purposes of determining compliance with the zoning ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATU- - Ow !Men - / DATE: <br /> Ordinances.Any unauthorized change from the information or . <br /> plans submitted will invalidate the permit. v <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 02/11/2015 RLB <br /> YES ® NO DATE REVIE D INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 01 olio-- cdJB <br />